How to Choose an Individual Health Insurance Plan

March 27, 2024

Finding a health care plan to suit your needs can be a frustrating experience, especially for those ages 50-65, who may not be covered by an employer but are not yet eligible for Medicare.

There are some obstacles to getting health insurance coverage that those in this particular age bracket face.

  • Finding a company that will cover you, especially if you have a pre-existing medical condition.
  • Getting coverage may require submitting yourself to a physical exam to prove you are healthy.
  • The rates may be higher than what you are used to when you had prior group plan coverage.
  • You might have less coverage at a higher cost.

It pays to research and compare different plans.

Choosing a plan

Be thorough in vetting a health care plan for yourself and your family. Consider these elements before making your decision.

  • The amount of medical care costs that will be covered: Think about doctor visits, as well as hospitalization. Find out what your copay will be for regular doctor visits, emergency room and specialists.
  • The premiums: Make sure the amount you’re required to pay for the plan fits into your budget. Some of this will depend on the deductible.
  • The deductible: Consider how much you can afford to pay out-of-pocket before your insurance kicks in. A higher deductible will translate into a lower monthly premium and vice-versa.
  • Preventive care: While each plan will offer preventive care, the details could vary.
  • Pre-existing conditions clause: Some plans will not provide coverage for you if you have a chronic condition or a serious medical problem.
  • Dental, vision and prescription coverage: You may have to purchase these services separately if you can’t find a plan that includes it for a price that fits your budget.
  • Limits: Some policies have limits on annual out-of-pocket costs. They may also have a lifetime limit that the insurance carrier will pay.
  • Providers and specialists: It’s very important that you make sure there are providers who accept your plan in your area before you purchase the policy. Not every plan is available in every state; make sure the plan you prefer is a viable option before you buy it.

Getting some clarity

Finding a plan that fills the gap before you’re eligible for Medicare can be a challenge. There’s a lot to understand and an abundance of plans to consider. It can be hard to determine which one is right for you.

If you find yourself becoming overwhelmed by all the options, seek help from an independent insurance agent.

An agent is familiar with the details of health care plans and how to determine which one is best for you. The agent also knows how to simplify the fine print and help you understand the plan. Simply put, an independent agent is an advocate for you.

The UROne Benefits™ team is ready to help you with this difficult process. Contact us here or at 800-722-7331.

This post was originally published in April 2017; updated March 2024.